Marion Malone, Gideon Koren

Prenatal alcohol exposure is strongly associated with disruptive behaviour in childhood and antisocial behaviour later in life. There are numerous confounding risk factors in the lives of alcohol-abusing mothers that may contribute to the behaviour problems seen in their children, rather than direct brain injury by alcohol. In fact, many of these additional environmental and genetic risk factors for childhood behaviour problems co-occur with prenatal alcohol exposure and affect the same child, creating a confluence of risk. As a result, one cannot with any certainty attribute behaviour problems in an individual child to prenatal alcohol exposure. This has important clinical and legal implications.